Functional and Radiological Outcomes of Locking Compression Plate Osteosynthesis in Closed SCHATZKER Type V and VI Tibial Plateau Fractures: A Prospective Observational Study

Abstract

Background: Schatzker type V and VI tibial plateau fractures are complex bicondylar intra-articular injuries commonly resulting from high-energy trauma. Achieving anatomical reduction, stable fixation, and early mobilization remains challenging because of fracture comminution and associated soft-tissue compromise. Locking compression plate (LCP) fixation has emerged as an effective fixation strategy by providing angular stability and preserving biological fixation principles.

Aim: To evaluate the functional and radiological outcomes of locking compression plate osteosynthesis in patients with closed Schatzker type V and VI tibial plateau fractures without neurovascular injury.

Materials and Methods: This prospective observational study included 20 consecutive patients with closed Schatzker type V and VI tibial plateau fractures treated with open reduction and internal fixation using locking compression plates. Functional outcomes were assessed using the Knee Society Score (KSS), while radiological outcomes were evaluated using Rasmussen’s radiological criteria. Fracture union, operative parameters, complications, and factors influencing outcomes were analyzed using SPSS version 26.0.

Results: The mean age of the study population was 44.85±12.3 years, and 70% were males. Schatzker type V fractures accounted for 60% of cases, whereas 40% were type VI fractures. The mean radiological union time was 17.4±3.2 weeks. The mean Knee Society Score was 83.6±9.7, with 75% of patients achieving excellent-to-good functional outcomes. Radiological assessment demonstrated excellent or good outcomes in 75% of patients. A significant positive correlation was observed between radiological and functional outcomes (p=0.021). Type VI fractures required significantly longer operative time, greater blood loss, increased graft utilization, and prolonged union time. Postoperative complications occurred in 25% of patients, with no implant failure or non-union.

Conclusion: Locking compression plate osteosynthesis provides reliable fixation and satisfactory functional and radiological outcomes in closed Schatzker type V and VI tibial plateau fractures. Anatomical restoration of the articular surface and stable fixation are key determinants of successful clinical recovery.